What are the other Names for the Procedure?
- Ethmoidal Polypectomy
- Maxillary Polypectomy
- Nasal Polypectomy
What is Nasal Polyps Removal surgical procedure?
- Nasal polyps are abnormal growths that develop within the lining of the nasal passage of the nose
- Nasal Polyps Removal is a procedure that involves the removal of nasal polyps. It is also called Nasal Polypectomy
What part of the Body does the Procedure involve?
Nasal Polyps Removal involves the nose and the membrane lining.
Why is the Nasal Polyps Removal surgical procedure Performed?
Nasal Polyps Removal is performed for the following reasons:
- To restore breathing to normalcy, by removing obstructing polyp
- Treating polyps caused by chronic sinusitis
What are some Alternative Choices for the Procedure?
There are usually no alternatives to a surgical removal of the nasal polyps.
What are the Recent Advances in the Procedure?
Recent advances to Nasal Polyps Removal procedure include the use of advanced anesthesia methods, which lower the risk of surgical complications.
What is the Cost of performing the Nasal Polyps Removal surgical procedure?
The cost of Nasal Polyp Removal procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.
In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.
When do you need a Second Opinion, prior to the Procedure?
- It is normal for a patient to feel uncomfortable and confused by the information regarding Nasal Polyps Removal procedure and on what needs to be done.
- If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician
- Also, if the procedure involves multiple surgeries or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently
What are some Helpful Resources?
Complete Guide to Symptoms, Illness & Surgery; Written by H Winter Griffith, M.D.; Revised and updated by Stephen Moore, M.D. and Kenneth Yoder, M.D.; The Berkley Publishing Group, 5th Edition, New York, 2006
http://www.mdguidelines.com/nasal-polypectomy (accessed on 09/20/2014)
Prior to Nasal Polyps Removal surgical procedure:
How is the Nasal Polyps Removal surgical procedure Performed?
- Nasal Polypectomy procedure may be done under local anesthesia and/or general anesthesia. Local anesthetic medication may be used along with medication, to temporarily narrow down the blood vessels in the nose (to minimize bleeding during surgery)
- The surgeon visualizes the nasal cavity, using a device called the speculum that holds the nostril wide open
- The polyp is then identified, clamped, cut, and removed. Pressure may be applied to control any bleeding
- In another method, the surgeon passes an endoscope (a tube fitted with a camera) into the nasal cavity to directly visualize the polyp. The growth is then carefully removed, using specialized instruments
- Additional procedures to maximize drainage of blocked sinuses and widening of air passage may be performed, as needed. When all such procedures are performed together, the technique is collectively referred to as functional endoscopic sinus surgery (FESS)
- Nasal packing may then be placed to control any bleeding
Where is the Procedure Performed?
A Nasal Polyps Removal procedure is usually performed in an out-patient surgery center facility, or a hospital.
Who Performs the Procedure?
An otolaryngologist surgeon performs a Nasal Polyps Removal procedure.
How long will the Procedure take?
The Nasal Polypectomy procedure is usually completed in less than an hour.
What do you need to tell your Physician before the Procedure?
It is very important to provide the following information to your healthcare provider. This enables your healthcare provider in assessing the risks for the Nasal Polyp Removal procedure and helps avoid any unnecessary complications.
- Provide a complete list of medications you are currently, taking to your physician. This information is useful for a variety of reasons. For example, it can help your healthcare provider prevent complications due to a drug interaction
- If you are allergic to any specific medication or food items
- If you are taking blood thinners, such as aspirin, warfarin, herbal supplements, or any other such medications
- If you or your family members, have a history of bleeding disorders, or if there is a tendency to bleed more than normal
- If you have diabetes, high blood pressure, chest pains, or have previously suffered from a heart attack
- If you have ever been diagnosed with blood clots in your leg (deep vein thrombosis) or lung (embolism of lung)
- If you have a history of frequent bone fractures (this may affect bone-healing, if bones are involved as part of your procedure)
- A list of all previous surgical procedures you have undergone, like for example: Removal of appendix, gallbladder, or any other part, of your body; surgical repair of any body part, such as hernia repair, perforation of bowel wall, etc.
What Preparations are needed, prior to the Procedure?
- The physician may evaluate the individual’s medical history prior to Nasal Polyps Removal to gain a comprehensive knowledge of the overall health status of the patient including information related to the medications that are being currently taken
- Some medications increase a person’s chances of bleeding and it may be recommended to discontinue them for a period of time, before the procedure is performed
- Blood tests may be performed to determine if there is a bleeding tendency or any other medical conditions that prevents the person from undergoing the procedure
- Inform the physician if you are allergic to any local anesthetics, lidocaine, etc
- Avoid application of any cosmetics, deodorant, or topical medicines on the area, prior to the procedure
- It is advisable to quit smoking and the use of any nicotine based products, for a while, before the surgery
- Consumption of alcoholic drinks must also be avoided for a period of time, as instructed
- The patient must avoid eating or drinking at least 8 hours prior to the surgical procedure, depending on when the procedure is arranged
- For persons suffering from diabetes, it is important that the blood sugar stays within the normal range; if not their diabetologist may have to control blood sugar by recommending insulin and/or a combination of oral medicines
What is the Consent Process before the Procedure?
A physician will request your consent for Nasal Polyp Removal procedure using an Informed Consent Form.
Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.
You must sign the forms only after you are totally satisfied by the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.
What Tests are needed, before the Nasal Polyps Removal surgical procedure?
The following test may be performed prior to a Nasal Polyps Removal surgery:
- Routine blood tests
- CT scan of nasal sinuses
- Chest X-ray
- X-ray of sinuses
- Endoscopy of sinuses
What are some Questions for your Physician?
Some of the basic questions that you might ask your physician are as follows:
- What is a Nasal Polyp Removal procedure?
- Why is this procedure necessary? How will it help?
- How soon should I get it done? Is it an emergency?
- Who are the medical personnel involved in this procedure?
- Where is the procedure performed?
- What are the risks while performing the procedure?
- What are the complications that might take place, during recovery?
- How long will it take to recover? When can I resume normal work?
- How many such procedures have you (the physician) performed?
- Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
- What are the costs involved?
During the Nasal Polyps Removal surgical procedure:
What kind of Anesthesia is given, during the Procedure?
Local anesthesia by topical application or injection, and/or general anesthesia is administered for Nasal Polypectomy procedure.
How much Blood will you lose, during the Procedure?
The blood loss during an uncomplicated Nasal Polypectomy procedure is minimal.
What are the possible Risks and Complications during the Nasal Polyps Removal surgical procedure?
There are general factors that increase the risk of getting complications during surgery and they include:
- Obesity: Generally greater the degree of obesity, greater is the surgical risk
- Smoking: Longer the smoking history (in pack years smoked), greater the surgical risk
- Advancing age
- Poorly controlled diabetes, as evidenced by a high hemoglobin A1c and a high fasting glucose
- Poorly functioning kidney, as evidenced by increased BUN (blood urea nitrogen) and blood creatinine
- Poorly functioning liver, as evidenced by increased blood liver function tests
- Hypertension (increased blood pressure), especially if it is poorly controlled
- Poor nutritional status (malnutrition with mineral and vitamin deficiencies)
- Poor lung function, as evidenced by abnormal lung function tests
- History of bleeding disorders
- Longstanding illness, such as autoimmune disorders, chronic infections
- Poor immune system due to a variety of causes
The possible risks or complications that may arise during the Nasal Polyps Removal surgery are:
- Excessive bleeding
- Infection surrounding the surgical wound
- Injury to adjacent structures
- Anesthetic complications
What Post-Operative Care is needed at the Healthcare Facility after the Nasal Polyps Removal surgical procedure?
At the healthcare facility, usually there is no requirement for any post-procedure care, unless any complications arise.
After the Nasal Polyps Removal surgical procedure:
What are the possible Risks and Complications after the Nasal Polyps Removal surgical procedure?
The possible risks and complications that may arise after Nasal Polyps Removal procedure are:
- Excessive bleeding
- Infection in the surgical wound
- Scarring with narrowing of nasal passage
What is the Prognosis after the Surgery?
A complete recovery from a Nasal Polyps Removal procedure is normally achieved. The prognosis is usually excellent, without any serious complications being noted.
When do you need to call your Physician?
Do contact your physician if you notice any of the following symptoms after the Nasal Polyps Removal procedure:
- Pain that worsens and swelling of the surgical wound
- Bleeding or fluid drainage from the surgical wound
- The occurrence of any symptom that causes uneasiness, like nausea or vomiting
- Signs of an infection
- Muscle aches, headache
- Fever, feeling sick
- Complications associated with prescription medications used in treatment
What Post-Operative Care is needed at Home after the Nasal Polyps Removal surgical procedure?
At home, the following post-operative care is recommended, after a Nasal Polyp Removal procedure:
- Avoid blowing your nose for the first 3 days after the procedure
- The physician may advice daily nasal irrigation with saline
- Applying warm compress a few times a day to the nose after the procedure, can help relieve mild discomfort
- Complete the course of prescribed medication, as advised by your physician
- Take antibiotic medication to help combat or prevent infection, under advise from your physician
- Avoid taking nonprescription medications, such as aspirin. However, individuals may take acetaminophen to relieve pain (as prescribed)
- Eat a well-balanced diet, which can aid in a faster recovery
How long does it normally take to fully recover, from the Procedure?
It usually takes approximately 2 weeks to fully recover from the Nasal Polyps Removal procedure.
What happens to tissue (if any), taken out during the Procedure?
The tissue is taken for further examination and later disposed as per the standard medical procedure.
When should you expect results from the pathologist regarding tissue taken out, during the Procedure?
- The tissue removed is processed in the laboratory under a pathologist's supervision
- Slide(s) are prepared once the tissue is processed and is examined by a pathologist and a pathology report issued
- Depending on the complexity of the case, issue of the report may take anywhere between 72 hours to a week's time
Who will you receive a Bill from, after the Nasal Polyps Removal surgical procedure?
It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers.
Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:
- The outpatient facility or a physician’s office/clinic
- An anesthesiologist (if anesthesia was administered)
- A pathologist
- An otolaryngologist
The patient is advised to inquire and confirm the type of billing, before the Nasal Polyps Removal procedure is performed.
Thanks and Gratitude:
We sincerely acknowledge and thank Dr. Douglas J. Jones for reviewing the article. His valuable input and feedback has helped enrich the contents of this article.
Douglas J. Jones, MD FACS
Board Certified General Surgeon and Faculty Member
University of Illinois, College of Medicine at Urbana-Champaign
506 S. Mathews Ave., Urbana, IL 61801, USA